Thursday, February 27, 2014

Think Twice - Mammograms - Friend or Foe?

Cancer seems to be the plague of our times. Is there anybody who hasn't lost a loved one to this menace? Everywhere we turn, we are advised on what behaviors to avoid and which actions to take if we want to minimize our chances of having to deal with this horrible set of diseases.

No one wants to hear the words, "You have cancer." So, we follow the advice of our doctors - keep your weight down, get regular exercise, don't smoke - you know the drill. And, if you're a woman over the age of 40, what have you been told over and over? That's right, be sure to get your yearly mammogram, it's your first line of defense against breast cancer.

But now, the scientific community is all abuzz about the not-so-great aspects of mammograms.

Like what?

Well, for one thing, regular mammogram screenings don't reduce breast cancer deaths.

Yes, you read that right.

Mammograms apparently don't do the one thing that they're supposed to do.

Yearly mammograms, we are told,  help catch breast cancer in the early stages, when it can be treated more effectively, thereby saving many lives.

Great theory, not so great in real life.

Thanks to a ground-breaking Canadian study, involving 90,000 women and 25 years of follow up, we now know a thing or two about a thing or two.

The researchers concluded:

"Annual mammography in women aged 40-59 does not reduce mortality from breast cancer beyond that of physical examination or usual care when adjuvant therapy for breast cancer is freely available. Overall, 22% (106/484) of screen detected invasive breast cancers were over-diagnosed, representing one over-diagnosed breast cancer for every 424 women who received mammography screening in the trial."

But wait, there's more.

What are the effects of regularly irradiating our breasts? Well, it depends on who you talk to. Some say that it's less harmful for post-menopausal women, others insist that any unnecessary radiation is harmful. The truth is that we really don't know yet. And I have to ask, if we don't know, shouldn't we be erring on the side of caution?

Let's talk about the high rates of false positives. Common sense might say, well, it's better to have a mammogram and "find" something that isn't there than to forego a mammogram and miss a cancerous mass that can lead to death.

In this case, common sense would be wrong. Even as far back as 1995, the medical journal, The Lancet, had this to say:

"About 5% of screening mammograms are positive or suspicious, and of these 80-93% are false positives that cause much unnecessary anxiety and further procedures including surgery. False reassurance by negative mammography occurs in 10-15% of women with breast cancer that will manifest clinically within a year."

In other words, according to this article, not only are most positives false, but the mammograms regularly miss 10-15% of cancers.


Look, I'm not saying don't get a mammogram. What I am saying is, educate yourself. Know the pros and cons of any treatment or procedure that is offered to you. Science is constantly evolving and new finding often negate what we've long thought to be true.

It would be fairly easy to tally up the millions of dollars spent on unnecessary treatments like surgeries, chemotherapy and radiation treatments. But the real cost, the stress of believing that you have a terminal disease, the suffering from cancer treatments, the loss of breast tissue to mastectomies, strains put on relationships - how can we ever add that all up?

And, speaking of costs. If we have known for at least 20 years that mammography isn't all that effective, and might actually be quite harmful, why are we being bombarded by messages to be sure and get one every year?

I'll let you figure that one out.

For further reading, I highly recommend the following articles:

FAIL: Another Mammography Study Finds They Don't Save Lives

Be Aware of the Dangers of Mammography

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